Intravenous (IV) infusion refers to fluid administration through the steel needle or plastic catheter inserted in the patient’s vein. Infusion implies that either the flow rate is slow or the total time duration of administration is not fixed. For instance, a medical doctor will order that one liter of fluid be infused for 8 hours. After infusing the first liter of fluid, another one will follow, and so on, for as long as the patient needs it. In this situation, the flow rate is slow and to be infused for an indeterminate period. This is an IV infusion.
Intravenous bolus is administering medication admixed in a fluid through the steel needle or plastic catheter inserted in the patient’s vein. IV bolus is often used in emergency situations; hence, the faster rate of administration is generally meant. In IV bolus, two critical things are specified:
(1) the volume of fluid to be administered, like 100 ml, 200 ml, or 250 ml, and
(2) the time duration to infuse it, like 15 minutes, 30 minutes, etc.
For example, a medical doctor will order that 10 ml of Drug A be admixed in 100 ml of saline water and then infused for 30 minutes. A set volume was specified (100 ml), and the time duration of administration was also specified (30 minutes). This is an IV bolus.
- To replace losses in fluids and electrolytes and to maintain them.
- To provide nutritional support to patients who cannot absorb their foods through their intestines.
- To deliver intermittent medications or fluid.
- To administer blood and blood products.
- To provide rapid delivery of a particular medication through the IV route, thereby achieving its peak level in the patient’s system in a short time and thereby benefiting from the intended results after a short time.
- To inject a certain amount of contrast medium to increase the visibility of blood vessels in x-ray procedures.
Precautions and limitations
- Label. Always read the Label on the infusion product before using it. Write on the Label the patient’s name, the bed number, and the drug(s) incorporated in the fluid to be infused.
- Incompatibilities. Suppose drugs are incorporated into the infusion product. In that case, medical staff should consider and watch the possibility of physical and chemical incompatibilities and act pre-emptively.
- Contamination. Ensure that the IV fluid is free from living microorganisms. In addition, in the process of inserting the needle of the infusion set, observe and practice the aseptic technique by applying antiseptic solutions such as isopropyl alcohol and related substances on the insertion site before pricking it with the needle. Do not remove the needle cap long before the insertion. Remove it only immediately before insertion. If there is doubt about the sterility of the IV fluid, discard the product.
- Irritating Drugs. As much as possible, know the pH of your IV product. If it is highly concentrated and very likely to irritate the veins, mix it in another IV solution to make it less irritating. For instance, do not infuse a combination of potassium chloride and dextrose solutions with concentrations higher than 10 percent through a peripheral vein because of their irritating local effects.
- Particulate Matter. Before infusing, examine the bottle of IV fluid in front of a light. When there is visible particulate matter, never use the product. If the product is cloudy, the product might contain suspended particulate matter. Do not use a cloudy solution.
- Removal of the catheter. The peripheral IV catheter needs to be removed (1) every 72 to 96 hours, (2) when the patient is stable enough and does not require IV fluid, (3) if the insertion site is painful, swollen, or with purulent discharge, and (4) when the administration set (IV tubings) is changed.
- Recipients: Intravenous bolus administration is not for everyone or everybody. Some patients cannot immediately process the medication or fluid administered in IV bolus because they have current medical problems. In this situation, refrain from using bolus administration; otherwise, their organs will be damaged. Patients with swollen legs, heart problems, or low urine output are not qualified to receive IV bolus administration of drugs or medications.
- Suitability: Not all drugs are suitable for IV bolus. When given so rapidly into the venous system of the patient, some drugs inflict harm.
- Requirements for the prescription. When a medical doctor prescribes an intravenous bolus administration, he needs to specify the following: (1) the name of the drug, (2) the amount of the drug, and (3) how long in terms of minutes it should be infused or administered.
- Limitation of volume: Some medications need to be diluted before infusing. If the resulting volume is too large, refrain from giving it via the IV bolus administration. Instead, hook the infusion set of the additional fluid into the primary intravenous line.
- Diameter of needle: Before doing the IV bolus administration, consider the diameter of the needle, which is one factor in calculating how long the bolus will take.
- Stability of the needle: Before doing the bolus, insert the needle correctly and firmly.
Summary of differences
|Points of differences||Intravenous infusion||Intravenous bolus|
|Amount of fluid involved||1 liter or more containing fluid and electrolytes||1-3 liters or less, usually containing a drug or medication|
|Schedule||Continuous infusion||Intermittent administration|
|Duration of administration||Variable, based on the indication or reason for fluid therapy and specific patient needs||A few seconds up to 30 minutes|
|General use||For maintenance and elective procedures||For emergency and life-threatening situations|
|Precautions and limitations||As enumerated in the preceding||As enumerated in the preceding|
Advantages of both intravenous infusion and bolus
- Both provide the most complete amount of drug into the system with a minimal delay,
- The controllable administration rate makes it easier to attain the required plasma concentration of the drug,
- If unexpected side effects are observed during the administration, the procedure can be halted at any time,
- IV route of administration allows better entry of some medications into the venous system of the patient compared to the oral route, and
- Painful intramuscular and subcutaneous injections can be avoided by having an IV route of administration.